Coming for colposcopy following an abnormal or inadequate cervical sample

Coming in for a colposcopy

You have an appointment for a colposcopy. This leaflet explains what is involved. Please read it carefully and keep it for reference.

If you cannot attend your appointment, you must telephone the colposcopy coordinators, giving as much notice as possible so that your appointment slot can be used by someone else.

Why you need a colposcopy

Your general practitioner or practice nurse will have explained that, because you have had one or more abnormal cervical cytology samples (smear) results, you need further tests to find out the cause. You may have had three smears reported as inadequate and a repeat smear may be all that is necessary at this visit. Colposcopy is part of preventing cancer of the cervix and helps us to decide whether you need treatment.

What is colposcopy?

Colposcopy is looking at the neck of the womb (cervix) and vagina, using a magnifying instrument called a colposcope. The procedure is done in the outpatient clinic. A general anaesthetic is not required and therefore you can eat and drink as normal.

When you come for your appointment

The procedure takes approximately 15 to 20 minutes. You are advised to have a friend or relative to accompany you as sometimes the procedure can make you feel dizzy or faint. We ensure that you are fully recovered before you leave the department.

When you arrive at the clinic you will be checked in by the receptionist. If your name, address or GP has changed since your appointment was made, please telephone the colposcopy coordinator (telephone number above) before you come, so that your records can be amended before you arrive.

If you would like to speak to a trained nurse before seeing the colposcopist, please inform the coordinator or receptionist.

Occasionally there are observers in clinic, such as medical students, practice nurses. If you do not want them to be present during your appointment, please tell the receptionist on arrival. You will see a colposcopist and there will be nurses who will support you during the procedure.

Occasionally the service undertakes audit or research that you may be invited to participate in. You will be given information regarding this if it is occurring.

At each clinic visit you will be asked to give the date of the first day of your last menstrual period. Colposcopy treatment cannot be performed if you are having a period, unless it is exceptionally light. If you are taking the contraceptive pill there is no need to miss an appointment. If your appointment comes during your pill free week, when you would expect to be bleeding, then you can take two packets continuously, with no break in between. You should then be free of bleeding for your appointment. Please refer to the information in your pill packet.

Avoid becoming pregnant

It is best to avoid pregnancy until colposcopy and subsequent treatment is completed. If you are using no form of contraception it is advisable to avoid sexual intercourse midcycle or use barrier methods such as condoms from the first day of your last period.

If you are pregnant, what will happen?

If you are pregnant, it is still important that you attend for a colposcopy. It is safe to perform a colposcopy and/or biopsy in pregnancy, although a biopsy is rarely taken. Treatment is not undertaken. After examination you may be asked to make an appointment to be seen in your second trimester or for three months after the delivery of your baby for a further colposcopy

If you have a coil (ICUD / IUS)

Your coil may be removed if you require treatment as the threads can get cut off during the procedure. If you undergo treatment you may therefore become pregnant if you have had sex since your last period.

To prevent pregnancy you are advised to arrange an alternative method of contraception or to use an additional method such as condoms, from the first day of your last period, before your colposcopy appointment.

What happens during the examination?

You will lie on a special couch with your legs supported. The examination takes about ten minutes. It is similar to having a smear taken (which may be repeated). A metal speculum is passed into your vagina to enable the colposcopist to get a good view of your cervix. The colposcope does not go inside you.

If necessary, swabs may be taken to detect any infection on the cervix. A solution of mild vinegar is washed over the cervix and makes any abnormal areas appear white. If any abnormal areas are seen, the colposcopist may take a tiny sample (called a biopsy) or you may be offered treatment (loop diathermy). This depends on your referral smear result which will have been discussed with you during the consultation.

You can watch the procedure, if you wish, on a TV screen that is by your side. After the examination the colposcopist will explain what they have seen and whether or not you will require any treatment. If necessary you may be asked to make a further appointment for treatment before you leave the clinic, or an appointment may be sent when the result of the biopsy has been received, in about four weeks time.

Occasionally, the procedures performed may cause some slight discomfort. They should not be painful. If you have any concerns please speak to your colposcopist.

Aftercare following cervical biopsy

If you have had a small biopsy taken, you may experience some spotting or discoloured discharge for a day or two. You will need to wear a pad to protect your underwear. Please bring a sanitary pad with you. An advice sheet will be given to you following the procedure.

What are the treatments performed in the outpatient clinic?

• Loop diathermy (LLETZ)

The colposcopist injects some local anaesthetic into your cervix. A wire loop is then used to remove the abnormal cells.

You will be given written information about the treatments at your first appointment, should you require it.

Aftercare following treatment

You are advised to make arrangements to have a quiet day and rest following loop diathermy treatment as you may feel dizzy or faint following the procedure. You should refrain from sexual intercourse for three to four weeks to allow the cervix to heal and prevent infection being introduced while the cervix is still healing. For the same reason you should use sanitary towels and not tampons.

There is a risk of heavy bleeding following the treatment. In view of this we usually advise that you avoid going abroad for three weeks following treatment.

There are no known health grounds for avoiding travel following treatment. However, medical attention for complications arising from the treatment may not be covered by insurance and you are advised not to go swimming for at least two weeks.

Avoid strenuous exercise or heavy lifting during this time but normal activities including light exercise may continue. You are less likely to bleed if you take this advice.

Loop treatment (LLETZ) has shown to be associated with a small increased risk of pre-term delivery and low birth weight in subsequent pregnancies. However, this very small risk is more than outweighed by the benefits of removing the abnormal cells from your cervix which if left untreated are at risk of developing into cancer in the future.

If you have any concerns regarding this please discuss them with your Colposcopist.

You may also find the website Jo’s Trust helpful (opens in a new tab). They have a section on LLETZ treatment, what to expect and aftercare

Very occasionally

You may require treatment for viral infections or inflammation of the cervix which is usually a course of antibiotics.

Although you are very unlikely to have anything seriously wrong with you, you will not be alone in feeling anxious. If you would like to speak to the colposcopy nurse before your appointment the number is 01223 216603. Please phone Monday to Friday 09:00 to 15:00.

Useful websites

• Cancer Screening (NHS Website) (opens in a new tab)
• BSCCP (opens in a new tab)
• Jo's Trust (opens in a new tab)